Writing the Employee Absence Report Form document
Employee Absence Report Date Reported Current Date. Employee: First Last Job title of signator, authorized signature or signer. Contract Job Title Department: Department Supervisor: Supervisor Period of Absence Start Date to End Date.
Supervisor must complete the following form and file it with the Human Resources Department.
Reason for Absence
Notification Method Phone: ? Writing: ? Other: ? Notes:
Action Taken Pay Deduction: ? Vacation/Personal Leave Deduction: ? Made up time: ? No action taken: ? Other: ? Notes:
Supervisor Signature Date
Address Address City, State Postal Code.
Phone Phone Number